Types of dehydration in children

Mild dehydration may show as thirst, a dry mouth, fewer wet nappies or toilet visits, and darker urine. Moderate dehydration can cause reduced tears, sunken eyes, unusual sleepiness, irritability, cool hands and feet, or faster breathing. Severe dehydration may involve extreme drowsiness, confusion, very little or no urine, weak pulses, or difficulty waking the child. Fluid loss can be mainly water, or water and salts together, so a child may need more than plain water.

Common triggers include vomiting and diarrhoea from gastroenteritis, heat exhaustion, fever, or poor intake. Constipation can accompany low fluid intake, but cloudy or dark urine can also have other causes.

Offer frequent small sips of an oral rehydration solution, following the product directions. Continue breastfeeding, and offer usual age-appropriate food when tolerated. Avoid forcing a large drink at once because it may trigger vomiting. Track wet nappies or urination, vomiting, diarrhoea, alertness, and the ability to drink. A clinician should advise on rehydration for babies, children with ongoing losses, or children who cannot keep fluids down.

Get urgent help if a child is difficult to wake, confused, breathing unusually fast, has very little urine, cold mottled skin, repeated vomiting, blood in vomit or stool, severe abdominal pain, or cannot drink. Babies and children with a chronic illness can worsen quickly, so seek advice early when wet nappies or urination fall noticeably.

Ask which solution and amount are suitable, how to monitor urine and alertness, when normal drinks and food can resume, and whether another illness is causing the fluid loss.